肾小球滤过率(GFR)是判断有无慢性。肾脏病的重要指标。目前有多种 GFR 检验方法,包括放射性核素标记物检测、内生肌酐清除率检测、血清β_2微球蛋白及胱蛋白酶抑制物检测等。近年,又提倡用公式估算 GFR(eGFR)替代上述检验,国外成人常...肾小球滤过率(GFR)是判断有无慢性。肾脏病的重要指标。目前有多种 GFR 检验方法,包括放射性核素标记物检测、内生肌酐清除率检测、血清β_2微球蛋白及胱蛋白酶抑制物检测等。近年,又提倡用公式估算 GFR(eGFR)替代上述检验,国外成人常用的估算公式有 Cockcroft-Gauh 公式及简化。肾脏病膳食改良试验(MDRD)公式,它们并不完全适用于国人,所以国内也开发了几个国人eGFR 估算公式。这么多 GFR 检测方法在临床上如何正确应用在不同慢性肾脏病分期中它们的检测结果可能出现什么偏差这些问题都非常值得研究。展开更多
应用放射性核素功能测定或肾动态显像获得肾小球滤过率(GFR)是临床常用的测量方法,核素显像的特点在于获得肾血流和尿路排泄系列影像的同时计算 GFR 及其他参数,方法实用简便,GFR 数值通常与临床判断或与其他计算 GFR 的方法相吻合。但...应用放射性核素功能测定或肾动态显像获得肾小球滤过率(GFR)是临床常用的测量方法,核素显像的特点在于获得肾血流和尿路排泄系列影像的同时计算 GFR 及其他参数,方法实用简便,GFR 数值通常与临床判断或与其他计算 GFR 的方法相吻合。但核素显像测量 GFR 受多种因素的影响,包括测量放射性剂量的准确性、"弹丸"注射技术、患者的体形变异和肾脏位置差异、肾脏疾病严重程度和肾外因素干扰、计算机处理方法和操作技能因素等,因此计算 GFR 的精确度存在不确定性,临床要特别注重参考其他相关指标综合评估肾脏的功能状态。展开更多
AIM: To investigate the effects of different methylenetetrahydrofolate reductase(MTHFR) 677C>T gene polymorphism and hyperhomocysteinemia for the development of renal failure and cardiovascular events, which are co...AIM: To investigate the effects of different methylenetetrahydrofolate reductase(MTHFR) 677C>T gene polymorphism and hyperhomocysteinemia for the development of renal failure and cardiovascular events, which are controversial.METHODS: We challenged the relationship, if any, of MTHFR 677C>T and MTHFR 1298A>C polymorphisms with renal and heart function. The present article is a reappraisal of these concepts, investigating within a larger population, and including a subgroup of dialysis patients, if the two most common MTHFR polymorphisms, C677 T and A1298 C, as homozygous, heterozygous or with a compound heterozygous state, show different association with chronic renal failure requiring hemodialysis. MTHFR polymorphism could be a favorable evolutionary factor, i.e., a protective factor for many ominous conditions, like cancer and renal failure. A similar finding was reported in fatty liver disease in which it is suggested that MTHFR polymorphisms could have maintained and maintain their persistence by an heterozygosis advantage mechanism. We studied a total of 630 Italian Caucasian subject aged 54.60 ± 16.35 years, addressing to the increased hazard of hemodialysis, if any, according to the studied MTHFR genetic polymorphisms. RESULTS: A favorable association with normal renal function of MTHFR polymorphisms, and notably of MTHFR C677 T is present independently of the negative effects of left ventricular hypertrophy, increased IntraRenal arterial Resistance and hyperparathyroidism. CONCLUSION: MTHFR gene polymorphisms could have a protective role on renal function as suggested by their lower frequency among our dialysis patients in end-stage renal failure; differently, the association with left ventricular hypertrophy and reduced left ventricular relaxation suggest some type of indirect, or concurrent mechanism.展开更多
文摘肾小球滤过率(GFR)是判断有无慢性。肾脏病的重要指标。目前有多种 GFR 检验方法,包括放射性核素标记物检测、内生肌酐清除率检测、血清β_2微球蛋白及胱蛋白酶抑制物检测等。近年,又提倡用公式估算 GFR(eGFR)替代上述检验,国外成人常用的估算公式有 Cockcroft-Gauh 公式及简化。肾脏病膳食改良试验(MDRD)公式,它们并不完全适用于国人,所以国内也开发了几个国人eGFR 估算公式。这么多 GFR 检测方法在临床上如何正确应用在不同慢性肾脏病分期中它们的检测结果可能出现什么偏差这些问题都非常值得研究。
文摘应用放射性核素功能测定或肾动态显像获得肾小球滤过率(GFR)是临床常用的测量方法,核素显像的特点在于获得肾血流和尿路排泄系列影像的同时计算 GFR 及其他参数,方法实用简便,GFR 数值通常与临床判断或与其他计算 GFR 的方法相吻合。但核素显像测量 GFR 受多种因素的影响,包括测量放射性剂量的准确性、"弹丸"注射技术、患者的体形变异和肾脏位置差异、肾脏疾病严重程度和肾外因素干扰、计算机处理方法和操作技能因素等,因此计算 GFR 的精确度存在不确定性,临床要特别注重参考其他相关指标综合评估肾脏的功能状态。
文摘AIM: To investigate the effects of different methylenetetrahydrofolate reductase(MTHFR) 677C>T gene polymorphism and hyperhomocysteinemia for the development of renal failure and cardiovascular events, which are controversial.METHODS: We challenged the relationship, if any, of MTHFR 677C>T and MTHFR 1298A>C polymorphisms with renal and heart function. The present article is a reappraisal of these concepts, investigating within a larger population, and including a subgroup of dialysis patients, if the two most common MTHFR polymorphisms, C677 T and A1298 C, as homozygous, heterozygous or with a compound heterozygous state, show different association with chronic renal failure requiring hemodialysis. MTHFR polymorphism could be a favorable evolutionary factor, i.e., a protective factor for many ominous conditions, like cancer and renal failure. A similar finding was reported in fatty liver disease in which it is suggested that MTHFR polymorphisms could have maintained and maintain their persistence by an heterozygosis advantage mechanism. We studied a total of 630 Italian Caucasian subject aged 54.60 ± 16.35 years, addressing to the increased hazard of hemodialysis, if any, according to the studied MTHFR genetic polymorphisms. RESULTS: A favorable association with normal renal function of MTHFR polymorphisms, and notably of MTHFR C677 T is present independently of the negative effects of left ventricular hypertrophy, increased IntraRenal arterial Resistance and hyperparathyroidism. CONCLUSION: MTHFR gene polymorphisms could have a protective role on renal function as suggested by their lower frequency among our dialysis patients in end-stage renal failure; differently, the association with left ventricular hypertrophy and reduced left ventricular relaxation suggest some type of indirect, or concurrent mechanism.
